Everyone, from Mayor Bob Filner to his harshest critics, agrees that his behavior has been “inexcusable.” But is it explainable? Is it treatable?

On Friday, the mayor apologized for his “inexcusable” actions and promised to enter an unnamed residential treatment center on Aug. 5. He’ll undergo two weeks of treatment, followed by a program of ongoing counseling, “to begin the process of addressing my behavior.”

“Begin,” experts insisted, being the key word.

“There is no two-week cure — I wish there was,” said Dr. Mark A. Kalish, a San Diego psychiatrist who often testifies as an expert witness in sexual harassment lawsuits. “This idea that there is some clinic that is going to fix him in two weeks, I can’t imagine who or what that would be.

“What could be done, is to start an educational process and a process of psychotherapy.”

But that’s a long road, with many potholes and potential detours. Like other troubled and troubling men before him, the mayor will have to change his behavior, which would involve re-evaluating the very traits that have made him a successful politician.

While no two harassers share the same history or motivations, ask experts to plumb the depths of the personality profile, and some red-flag traits bob to the surface. Narcissism, or the excessive interest in one’s own importance and abilities. A delight in defying expectations. A love of power. All qualities that can lead to success in the hypercompetitive world of politics but can spell big-time trouble in the wrong hands.

“(For harassers) power is an intoxicant, as it is with most men,” said James A. Reavis, a forensic psychologist in Mission Valley and director of forensic services at the Relationship Training Institute. “There are healthy and unhealthy degrees of narcissism. To be a powerful man, you have to have healthy degrees of narcissism to take the slings and arrows of other people. If you have a more balanced personality, you can feel good about the power you have. But with some guys, it becomes all consuming, and you can delight in demonstrating your power by flexing your muscles over other people.”

Bad role models

Despite the term, sexual harassment is not really about sex. Even the suggestive comments or inappropriate touches are exercises in dominance. And generally, only one person is in charge.

“The emphasis is on the power and control,” said Clark R. Clipson, a forensic psychologist with a Mission Hills practice. “Even if they do obtain sex, they’ve obtained it through intimidation rather than forming a relationship with a willing participant.”

What turns some men into harassers? There is no single answer. LawRoom, a California firm that has provided sexual-harassment awareness programs for more than 3,000 companies nationwide (including U-T San Diego), cites numerous theories, including the view that an early trauma may make potential harassers lose their ability to empathize.

Others say abusive childhoods can be a factor. There could be bad role models at home or in the workplace. They could get a charge out of shocking people. They could be insecure, bolstering their self-esteem or social standing by degrading others. They may have an innate hostility toward women.

“In many cases, he’s not suffering from some kind of an unusual sexual urge,” Reavis said. “This is more of a psychological nature. He is getting off on the power involved with manipulating other people.”

So what can be done? Filner shared few specifics about his treatment and took no questions from reporters Friday. He did say the treatment would begin with two weeks of intensive therapy.

In treatment circles, that is known as the first of many, many steps.

“If you are really going to clean the machine, that takes a lot longer,” said Reavis. “Generally what you help the person do is go back to the first 18 years of life when your personality is first developing and identify events from his past that caused him to feel insecure, and help him recognize that he is compensating for that insecurity by arrogance and the devaluation of other people.”

Local clinical and forensic psychologist Dr. Ellen Stein has consulted for several years with the Institute for Sexual Health in Beverly Hills, which treats “professional sexual misconduct” through its professional boundaries program.

The program begins with a psychosexual evaluation that can take three to five days. After the evaluation, patients go through behavioral containment, where they define their offending behaviors and develop a detailed plan on how to stop them. They are required to take responsibility for their behaviors and tackle such common defense mechanisms as minimization (“They knew I was just kidding”) and denial (“I did not have sex with that woman.”)

Patients learn what triggers their boundary violations, how to empathize with victims, how to read other people’s reactions to their behaviors and how to get back to work. There is also an aftercare element that includes monthly meetings and a mentorship program. Not to mention an extensive plan on what to do in case of a relapse.

“It’s fair to say that this is challenging treatment,” said Stein, who knows of at least one patient who relocated to Los Angeles to be closer to the institute and receive focused treatment. “It is challenging for the patient and it is challenging for the patient’s family and for the people affected by his behavior because it is hard for the lay public to know how effective that individual has become in containing their behaviors and impulses."

Two masters

The American Psychological Association does not classify sexual harassment as a “mental disorder,” and Kalish hesitates to use the term “addiction.”

“It’s different from drug abuse or alcoholism, of course, because there is no physiological addiction,” he said. “But certainly it impacts the mayor and those around him, his family — it seems to have impacted his relationship with his ex-fiancée. That’s serious.”

No matter what you call it, sexual harassment can’t be treated with a simple or brief course of therapy.

“Someone who is truly committed to making changes, you are looking at a process that will take six months to a year,” said Clipson. “That’s assuming they don’t have a personality disorder. If they do, it’s more in the range of two to three years.”

Psychologists praised Filner’s stated intention to follow his two-week intensive treatment with continued therapy. But some questioned his plan to be briefed on city activities every morning and evening during those first 14 days.

“How is he going to do the city’s business and be unavailable during the day for two weeks?” Kalish asked. “Either the therapy is going to suffer or the city is going to suffer. You can’t serve two masters at once.”

Agreeing to seek treatment is a big step. But once the therapy begins, painful realities surface and new challenges arise.

“When they are self-referred, they don’t have a lot of motivation to stay because there are a lot of benefits to thinking of themselves as entitled and superior to other people,” said Reavis. “There isn’t a lot of benefit for them to develop a more realistic self-perception. You have to go back and uncover the sources (of the behavior), and sometimes when you do it’s too painful and they don’t want to do it.”

In the image-conscious world of politics, it’s hard for public officials to admit to any imperfection. So recovery can get lost in the spin cycle.

“Sometimes,” Kalish said, “they get their own personalities confused with the office they hold. When we are being respectful to the president, the governor, the mayor, we are respecting the person holding the office, not necessarily the person. Sometimes they forget about that.”

Case in point: In 2006, Donald Thompson, a former Oklahoma judge, was sentenced to four years in prison for repeatedly exposing himself and employing a penis pump while presiding over jury trials.

“Why people in power just feel free to exercise their libidos — that’s a mystery,” said Kent Mannis, senior editor for LawRoom. “It seems almost childish.”

Perhaps so, but some say it’s understandable. Sexual harassment “has to do with narcissism, a sense of grandiosity and power,” Kalish said. “And do we want people as leaders who are powerful, can make decisions and can influence others? Yes.”

But only within reason.

“I’ve been married to my wife 32 years,” Kalish said. “Early on, she gave me a valuable piece of advice: ‘Mark, when you start believing your own B.S., that’s when you’ll be in trouble.’ ”